This study was undertaken to evaluate the clinical characteristics, perioperative features, and outcome of congenital intrinsic intestinal obstruction in a developing Caribbean country for comparison with previous literature reports. This study included retrospective data collection on all infants referred to the hospital with a diagnosis of congenital intrinsic bowel obstruction during the period 1999-2006. Data studied were demographic features, perioperative details, surgical procedures performed, postoperative course, and early outcome. Twenty-two infants were treated, with an incidence of 3.14 per 10,000 live births. Duodenal outnumbered jejuno-ileal lesions by 1.5 to 1. Complications occurred in 68.2% of cases, and the mortality rate was 27.3%. Lower gestational age, a high leukocyte count, and more distal small bowel obstruction were significantly associated with mortality. Improvement in the outcome of surgical treatment of this problem in this population requires more effective perioperative management of prematurity and sepsis.